Diversity of pneumococcal surface protein A (PspA) among prevalent clones in Spain

<p>Abstract</p> <p>Background</p> <p>PspA is recognized as a major pneumococcal virulence factor and a possible vaccine candidate. The aim of this study was to analyze the PspA family and clade distribution among 112 Spanish pneumococci representatives of dominant clones among patients with invasive disease (n = 66) and nasopharyngeal healthy carriage in children (n = 46).</p> <p>Results</p> <p>PspA family 2 was predominant among invasive (63.6%) and carriage (54.3%) pneumococcal isolates. No PspA family 3 isolates were detected and only one strain was PspA negative. Although four clonal complexes contained strains of different clades, a clear association between clade and multi locus sequence typing results was found. Clades 1, 3 and 4 were associated with a wide variety of sequence types (ST) related to multiresistant and antibiotic-susceptible worldwide-disseminated clones. Clade 1 was associated with Spain^6B-ST90, Spain¹⁴-ST18, Colombia⁵-ST289, Sweden¹-ST306, Denmark¹⁴-ST230 and Sweden¹-ST304 clones. Clade 3 was associated with Spain^23F-ST81, Spain^9V-ST156, Tennessee¹⁴-ST67, Netherlands³-ST180 and Netherlands^7F-ST191 clones. Clade 4 was related to Sweden^15A-ST63, Netherlands^18C-ST113 and Greece²¹-ST193 clones. In contrast, PspA clade was not related to serotype, age or clinical origin of the isolates.</p> <p>Conclusion</p> <p>PspA clades were associated with genotypes. PspA family 2 and family 1 were dominant among major Spanish pneumococcal clones isolated from patients with invasive disease and nasopharyngeal carriage in children.</p

Dissemination of multiresistant Enterobacter cloacae isolates producing OXA-48 and CTX-M-15 in a Spanish hospital

Twenty-one multiresistant Enterobacter cloacae isolates producing OXA-48 (n = 10), CTX-M-15 (n = 7) or both (n = 4) β-lactamases were detected in a Spanish hospital during a 1-year period (June 2013 to June 2014). The isolates were also resistant to non-β-lactam antimicrobials, further complicating the therapeutic options. Genotyping of the isolates identified two major clones (ST74 and ST66) that caused prolonged outbreaks in different buildings of the hospital as well as some sporadic isolates (ST78, ST45 and ST295). Isolates belonging to clone 1 (n = 7) were carbapenem-resistant and carried the blaOXA-48 gene on a conjugative IncL/M plasmid of ca. 65 kb. Clone 2 isolates (n = 11) were resistant to cefepime and harboured the blaCTX-M-15 gene on an ca. 150-kb, non-conjugative plasmid of the IncF group, co-harbouring the qnrB and aac(6′)-Ib-cr genes encoding quinolone resistance. Four clone 2 isolates were also resistant to carbapenems owing to the co-production of OXA-48. Most of the isolates were recovered from critically ill patients and were admitted to intensive care units; a single patient was transferred from another Spanish hospital. Intrahospital and interhospital dissemination of multiresistant E. cloacae isolates is of major clinical concern as it could lead to endemic nosocomial situations

Oropharyngeal colonization by nontypeable Haemophilus influenzae among healthy children attending day care centers

Haemophilus influenzae colonizes the upper respiratory tract and can spread causing otitis and sinusitis. This work aimed to study the oropharyngeal carriage rate in healthy <5-year-old children attending day care centers in Oviedo, Spain in two consecutive years (January to March 2004-2005). The carriage rate was 42% (400/960) and highly variable among centers (range, 12% to 83%). Isolates were mainly identified as nontypeable H. influenzae (NTHi, 99%). Epidemiologically, 127 different genotypes were identified by PFGE with a minimum of two genotypes per center. One hundred fourteen children (12%) were included in both studies and none of them harbored the same strain over a period of time. The isolates only showed resistance to cotrimoxazol and ampicillin, presenting a shift in the level of ampicillin reduced susceptibility, showing a predominance of PBP3 mutations in 2004 and a predominance of β-lactamase production in 2005. This study proved the great genetic variability of NTHi isolates that present similar genotypic patterns in both years with no long-term carriage of the same strain

Serotypes and genotypes of S. pneumoniae isolates from adult invasive disease in Spain: A 5-year prospective surveillance after pediatric PCV13 licensure. The ODIN study

Serotypes/genotypes causing invasive pneumococcal disease (IPD) in adults are determined by vaccina- tion strategies. The aim of this study was to assess the epidemiology of IPD in adults (!18 years) after PCV13 introduction for children: serotypes, clonal complexes, antibiotic non-susceptibility and clinical presentations. We performed a prospective, clinical surveillance of hospitalized culture-confirmed IPDs in adults in nine Spanish hospitals (August 2010-June 2015). A total of 1087 culture-confirmed IPD episodes were included, of which 772 (71.0%) had bacteremic pneumonia (401 complicated/371 uncomplicated pneu- monia), 122 (11.2%) meningitis, 102 (9.4%) non-focal bacteremia, 34 (3.1%) peritonitis and 57 (5.3%) others. The most common serotypes were: 3 (12.7%), 19A (8.5%), 8 (7.7%), 7F (6.3%), 1 (4.2%), 6C (4.2%), 11A (4.2%), 22F (4.2%) and 14 (4.0%). Vaccine types (PCV13 + 6C) caused 49.8% of IPD episodes, with a significant decrease over the 5-year period, and significant decreases in serotypes 6C and 7F. The most common genotypes were: CC180 (8.4%), CC191 (6.0%), and CC53 (5.0%). Vaccine types caused 53.9% (414/768) pneumonia episodes and 58.9% (235/399) complicated pneumo- nia, 53.4% IPD in adults <50 years (143/268), and 54.7% IPD in immunocompetent patients (337/616). Overall non-susceptibility was 25.9% to penicillin (1.1% for parenteral criteria), 24.9% to erythromycin and 2.7% to levofloxacin. Conclusions: Although the percentage of vaccine-types causing IPDs in adults significantly decreased, it remained high. Associations of vaccine types with pneumonia (with complicated pneumonia for specific serotypes), and immunocompetent patients point to the burden of IPD caused by PCV13 serotypes

Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study

BACKGROUND: The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL)--producing Escherichia coli and Klebsiella spp. bacteremia. METHODS: Cases of ESBL producing Enterobacteriaceae (ESBL-E) bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression. RESULTS: We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%), biliary tract (12.7%), intra-abdominal (8.8%) and unknown origin (9.6%). Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI): 0.39 (0.31-0.97); P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients. CONCLUSION: ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited

Análisis de la competencia del profesor de Educación Física para la inclusión de escolares con discapacidad

El estudio se enmarca en la competencia percibida por propios profesores de Educación Física para la inclusión de escolares primarios con discapacidad física. Se formuló como objetivo analizar la competencia percibida por profesores de Educación Física para la inclusión de escolares primarios con discapacidad física, en dos municipios de la región central de Cuba. Los datos provienen de un cuestionario cumplimentado por 40 profesores de Educación Física de dos municipios de la Región central cubana (divididos en dos grupos de 20). Se utilizaron métodos teóricos como el analítico-sintético y el inductivo-deductivo; y empíricos como la entrevista, la observación y la encuesta; del nivel matemático y/o estadístico, la distribución empírica de frecuencia. El resultado de la investigación reflejó la descripción de la autopercepción de los profesores de ambas poblaciones, en las tres dimensiones, con resultados más favorables para el municipio de Cabaiguán. La autopercepción más favorable de los profesores del municipio de Cabaiguán, para realizar adaptaciones específicas, emitir instrucción a los iguales y seguridad en el proceso de inclusión de escolares con discapacidad en la clase de Educación Física

Diversity of pneumococcal surface protein A (PspA) among prevalent clones in Spain

Background: PspA is recognized as a major pneumococcal virulence factor and a possible vaccine candidate. The aim of this study was to analyze the PspA family and clade distribution among 112 Spanish pneumococci representatives of dominant clones among patients with invasive disease (n = 66) and nasopharyngeal healthy carriage in children (n = 46). Results: PspA family 2 was predominant among invasive (63.6%) and carriage (54.3%) pneumococcal isolates. No PspA family 3 isolates were detected and only one strain was PspA negative. Although four clonal complexes contained strains of different clades, a clear association between clade and multi locus sequence typing results was found. Clades 1, 3 and 4 were associated with a wide variety of sequence types (ST) related to multiresistant and antibiotic-susceptible worldwide-disseminated clones. Clade 1 was associated with Spain6B-ST90, Spain14-ST18, Colombia5-ST289, Sweden1-ST306, Denmark14-ST230 and Sweden1-ST304 clones. Clade 3 was associated with Spain23F-ST81, Spain9V-ST156, Tennessee14-ST67, Netherlands3-ST180 and Netherlands7F-ST191 clones. Clade 4 was related to Sweden15A-ST63, Netherlands18C-ST113 and Greece21-ST193 clones. In contrast, PspA clade was not related to serotype, age or clinical origin of the isolates. Conclusion: PspA clades were associated with genotypes. PspA family 2 and family 1 were dominant among major Spanish pneumococcal clones isolated from patients with invasive disease and nasopharyngeal carriage in children

Diversity of pneumococcal surface protein A (PspA) among prevalent clones in Spain

Background: PspA is recognized as a major pneumococcal virulence factor and a possible vaccine candidate. The aim of this study was to analyze the PspA family and clade distribution among 112 Spanish pneumococci representatives of dominant clones among patients with invasive disease (n = 66) and nasopharyngeal healthy carriage in children (n = 46). Results: PspA family 2 was predominant among invasive (63.6%) and carriage (54.3%) pneumococcal isolates. No PspA family 3 isolates were detected and only one strain was PspA negative. Although four clonal complexes contained strains of different clades, a clear association between clade and multi locus sequence typing results was found. Clades 1, 3 and 4 were associated with a wide variety of sequence types (ST) related to multiresistant and antibiotic-susceptible worldwide-disseminated clones. Clade 1 was associated with Spain6B-ST90, Spain14-ST18, Colombia5-ST289, Sweden1-ST306, Denmark14-ST230 and Sweden1-ST304 clones. Clade 3 was associated with Spain23F-ST81, Spain9V-ST156, Tennessee14-ST67, Netherlands3-ST180 and Netherlands7F-ST191 clones. Clade 4 was related to Sweden15A-ST63, Netherlands18C-ST113 and Greece21-ST193 clones. In contrast, PspA clade was not related to serotype, age or clinical origin of the isolates. Conclusion: PspA clades were associated with genotypes. PspA family 2 and family 1 were dominant among major Spanish pneumococcal clones isolated from patients with invasive disease and nasopharyngeal carriage in children

La biodiversidad de los hongos ectomicorrízicos y su importancia para la conservación del bosque en la zona poblana del Parque Nacional Malintzi

El Parque Nacional Malintzi comprende una superficie de 45,852 hectáreas, de las cuales corresponden 14,544 al estado de Puebla. El deterioro a su riqueza forestal tiene sus inicios desde la época colonial y hasta nuestros días la presión sobre los recursos de este parque nacional aumenta debido a que los pobladores de la zona, tradicionalmente ven en la montaña su fuente de sustento mediante la agricultura y la extracción de madera, que aunadas a la tala clandestina inmoderada, han influido drásticamente en la pérdida de biodiversidad y cambio de uso del suelo. Los objetivos de este trabajo fueron describir la distribución espacial de los hongos macroscópicos, y su relación poblacional con respecto a la perturbación del ecosistema. La colecta de individuos, para conformar un herbario. Generar el cultivo del micelio o germoplasma, en el laboratorio registrando los parámetros físicos y condiciones nutrimentales que permitieran esta acción. Los puntos de muestreo se señalaron por el sistema GPS y se realizó la gráfica de distribución poblacional de una especie micorrízica. Entre los puntos de muestreo se examinó la aleatoriedad espacial completa, estimando la intensidad del patrón de puntos espaciales y la no existencia de interacciones entre ellos. La validez de las hipótesis planteadas se probó con las herramientas estadísticas del módulo S+SPATIALSTATS del sistema computacional S-PLUS 2000